Background
-PSD may be present at birth or may develop during the first few months of life.
-Incidence increased since the AAP’s “back to sleep” recommendations to reduce SIDs started. SIDs incidence has decreased but PSDs have increased.
-“Are generally benign, reversible head-shape anomalies that do not require surgical intervention, as opposed to craniosynostosis, which can result in neurologic damage and progressive craniofacial distortion.” Pediatrics 2011
Diagnosis
-H&P
-Differentiate PSD from craniosynostosis.
Treatment
“For the mild-to-moderate deformity, positioning and observation is the recommended treatment. Both positional changes and molding helmets are options for the infant with severe deformity. Cranial orthoses should be reserved for severe cases of deformity or for the infant whose deformity does not improve after 6 months of age. Referral to a pediatric neurosurgeon with expertise in craniofacial malformations, a craniofacial surgeon, or a craniofacial team should be considered if there is progression or lack of improvement after a trial of mechanical adjustments or suspicion of craniosynostosis.” Pediatrics 2011
Further Reading / Reference
Pediatrics Dec 2011, 128 (6) 1236-1241. Prevention and Management of Positional Skull Deformities in Infants. http://pediatrics.aappublications.org/content/128/6/1236